[Value of conformal radio therapy for middle stage or advanced primary hepatocellular carcinoma].

OBJECTIVE

To evaluate the value of conformal radio therapy in the treatment of primary hepatocellular carcinoma (HCC) in advanced stages.

METHODS

Altogether 198 patients with advanced HCC underwent three-dimensional conformal radio therapy (3D-CRT) in a dose range 48 to 63 Gy in 6 to 9 fractions completed in a course of 12 to 18 d. The total clinical tumor volume (CTV) received more than 90% of the prescribed irradiation dose delivered through 6MV X ray. CT examinations were performed before 3D-CRT and in the three-year follow-up period to verify the therapeutic effects.

RESULTS

Partial tumor remission was achieved in 81 cases (41%) 1 month after the treatment and 95 cases (48%) 3 months later. Ten cases (5%) failed to respond to the treatment, while the majority (186, 94%) showed tumor remission 6 months after the treatment, with only 2 cases (1%) had progression of the tumors. In the 48 patients with cancer embolus in the portal vein, 31 (65.6%) showed evidence of diminished embolus. The alpha-fetoprotein levels in the HCC patients were reduced significantly after the treatment (P=0.015). Among the stage-III patients 1-year survival rate was 68%, 2-year survival rate was 41%, and 3-year survival rate was 35%.

CONCLUSIONS

3D-CRT is an effective method for treating advanced HCC.